Kıratlı Kazım, Hirsi Ibrahim Mohamed, Çelik Burak, Aysin Murat, Ali Ahmed Mohamed, Turfan Selim, Zeybek Hakan
Mogadishu Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Mogadishu, Somalia.
Mogadishu Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital, Department of Pediatrics, Mogadishu, Somalia.
Int J Gen Med. 2024 Sep 3;17:3825-3836. doi: 10.2147/IJGM.S471130. eCollection 2024.
Despite the efforts and support of the World Health Organization and other international organizations to reduce the incidence of the disease, tetanus is still an acute condition with serious consequences, including death. The purpose of this study was to assess the tetanus patients we have been monitoring over the past two years in Somalia, a country with a protracted civil conflict, extreme poverty, and restricted access to hospital, social security, and public health facilities.
This study includes tetanus patients who were admitted to the Recep Tayyip Erdoğan Training and Research Hospital in Mogadishu, Somalia, Turkey between January 1, 2022, and November 1, 2023. Hospitalization, diagnosis, treatment, complications, death, and test results were all looked at in addition to the patients' sociodemographic details.
The average age of the 196 patients was 10 years, with males making up 67.9% of the total (min-max: 7 days-71 years). Acute injury was the cause of 53.1% of tetanus cases, with the legs being the most frequently injured body area (28.8%). A mean duration of stay of 11 days was observed for 82.1% of the patients who were monitored in the hospital (min-max: 1-38 days). The total fatality rate was 14.3%, and 85.7% of patients had never had a tetanus vaccination. The group with severe tetanus had higher rates of intensive care admission (p<0.001), generalized/neonatal tetanus (p<0.001), high non-vaccination rate (p:0.011), antibiotic usage (p<0.001), and a positive blood culture (p<0.001). Almost all of the complications (p<0.001) and all of the deaths (p<0.001) were in the severe group.
In sub-Saharan Africa, immunization rates are regrettably still insufficient despite the tetanus vaccine's low cost and great effectiveness. Public education and encouragement on anti-vaccination must continue alongside the enhancement of vaccination programs. Otherwise, low- and middle-income countries will still be plagued by this illness, which has been overlooked in high-income nations.
尽管世界卫生组织和其他国际组织为降低该疾病的发病率做出了努力并提供了支持，但破伤风仍然是一种会产生严重后果（包括死亡）的急性病症。本研究的目的是评估过去两年来我们一直在监测的索马里破伤风患者情况，该国长期处于内战状态，极度贫困，且难以获得医院、社会保障和公共卫生设施服务。
本研究纳入了2022年1月1日至2023年11月1日期间在索马里摩加迪沙的土耳其雷杰普·塔伊普·埃尔多安培训与研究医院住院的破伤风患者。除了患者的社会人口学详细信息外，还对住院情况、诊断、治疗、并发症、死亡情况及检查结果进行了研究。
196例患者的平均年龄为10岁，男性占总数的67.9%（最小 - 最大年龄：7天 - 71岁）。53.1%的破伤风病例由急性损伤引起，腿部是最常受伤的身体部位（28.8%）。在医院接受监测的患者中，82.1%的患者平均住院时间为11天（最小 - 最大：1 - 38天）。总死亡率为14.3%，85.7%的患者从未接种过破伤风疫苗。重症破伤风组的重症监护病房收治率（p<0.001）、全身性/新生儿破伤风发生率（p<0.001）、未接种疫苗率高（p:0.011）、抗生素使用率（p<0.001）及血培养阳性率（p<0.001）均较高。几乎所有并发症（p<0.001）和所有死亡病例（p<0.001）均出现在重症组。
在撒哈拉以南非洲地区，令人遗憾的是，尽管破伤风疫苗成本低廉且效果显著，但免疫接种率仍然不足。在加强疫苗接种计划的同时，必须继续开展关于反对接种疫苗的公众教育和劝导工作。否则，低收入和中等收入国家仍将受这种在高收入国家已被忽视的疾病困扰。
